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[MalloryD]

Hello to all!

I think I am in late peri or early meno, as I had about 5 cycles total last year, and my last period this year was in february.

I have been on HRT for the last 18 months, mostly to treat very frequent hot flashes (more than 20 per days!) and associated sleep problems.
I was at first given 25 ug patches. They worked great for about 6 months (hurrah, no more hot flashes and great sleep!), then the problem came back. My ob-gyn put me on 37,5 ug patches that helped but not that much, then on 50 ug patches that worked great for about 6 months too, it is my current prescription.

But for the last 3 months hot flashes and sleep problems have come back and I wake up every day around 4 with big hot flashes and my heart racing wildly, like a small panic attach (which never had before meno) and I can not go back to sleep, and I am thus very tired all the time... My ob-gyn think that I need to stay on a 50 ug dosage, as it is quite high already, and my estrogen blood level is high (250 pmol) but the not-sleeping enough at all is very hard on me. I need 8 to 9 hours to feel good!

Do you think that I need to live with very little sleep  ? Or do you think that it would be reasonable to try more oestrogen?

I am wondering if it is possible that my body 'get used' to whatever dose of oestrogen that I get, and that it stop functionning after a while. If that is the case, it would be silly to keep increasing the dose. For progesterone, I really notice this habituation. At first, the 14 days of the month wher I had it, I slept very long and very soundly, and during the day I felt sleepy and nauseous. Now, about 18 months later, I don't notice any difference between the days with and without progesterone.

Any advice appreciated 

[sheila99]

As your own production of oestrogen falls many people need to increase their dose. 50 is a medium dose. I started on 50 in peri and have increased twice because of returning symptoms (anxiety and insomnia) and now on 100. As an NHS patient my levels aren't tested, they go on symptoms. It seems individuals have differing levels where they feel good and it seems that for you this is higher than you have now. In your shoes I would increase.

[MalloryD]

Thank you very much for your answer 

My ob-gyn told me that 50 ug patches was a high dose, but as she is really against HRT, I guess she might be exagerating a bit.

[Kathleen]

Hello MalloryD and welcome to the forum.

I have always thought of 50mcg as a low to medium dose and I believe that it is the amount that many women are given when they begin HRT. The fact that you were prescribed less than this amount initially makes me think that your ob-gyn is being very conservative. If she is against HRT that is her  opinion but she shouldn't prescribe sub therapeutic levels to her patients. Perhaps look around  this site and arm yourself with more information before your next appointment.

Wishing you well and take care.

K.